Abstract
BackgroundThe adoption of ACT as the first line treatment for uncomplicated malaria in Nigeria has concentrated attention on the role of testing in appropriate malaria treatment. There are calls at both national and global level for malaria treatment to be based on test result, but it is still unclear how testing can be incorporated into treatment-seeking and practices of health providers. This study explored community members and health providers’ perceptions and experiences with malaria tests in south east Nigeria.MethodsThe study was conducted in urban and rural areas of Enugu state in south-eastern Nigeria. A total of 18 focus group discussions with 179 community members including sub-groups of primary caregivers, adult men and adult women aged 15 years and above. Twenty- six (26) In-depth interviews were held with public and private health providers involved in prescribing medicines at public and private health facilities in the study area.ResultsBoth providers and community members were familiar with malaria tests and identified malaria tests as an important step to distinguish malaria from other illnesses with similar symptoms and as a means of delivering appropriate treatment. However, the logic of test-directed treatment was undermined by cost of test and a lack of testing facilities but above all concerns over the reliability of negative test results, with community members and providers observing inconsistencies between results and symptoms, and providers attributing inaccurate results to incompetencies of technicians. Recognition of malaria symptoms was deemed most important in determining the use of antimalarial drugs rather than the result of a malaria test.ConclusionThe results highlight important areas of intervention to promote appropriate malaria treatment. If tests are to play a role in patient management, demand and supply side interventions are needed to change people’s attitude towards malaria test results.
Highlights
The adoption of artemisinin combination therapy (ACT) as the first line treatment for uncomplicated malaria in Nigeria has concentrated attention on the role of testing in appropriate malaria treatment
The adoption of artemisinin combination therapy (ACT) as first line treatment for malaria by many African countries including Nigeria has increased the emphasis on accurate malaria diagnosis before treatment to prevent the indiscriminate use of these drugs
In Nigeria it is not clear how these tests are perceived and how they could be incorporated into current treatment-seeking and prescribing practices of health care providers
Summary
The adoption of ACT as the first line treatment for uncomplicated malaria in Nigeria has concentrated attention on the role of testing in appropriate malaria treatment. In Nigeria it is not clear how these tests are perceived and how they could be incorporated into current treatment-seeking and prescribing practices of health care providers. Studies have shown that reliable diagnostic testing is severely limited in Africa, and misdiagnosis commonly occurs, which exacerbates morbidity, promotes the perception that testing is not useful, and compromises patient care [5]. Where these tests are being provided, there are common perceptions and beliefs about their accuracy and impact on patient care. In Nigeria, a study on availability and use of RDTs in public and private health facilities found limited use of RDTs in these facilities the main reasons given for non-use were unreliability of RDTs, supply issues, and preference for other methods of diagnosis [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
